READING LEVEL
The good, bad and oxidized faces of cholesterol.
Cholesterol is often berated for its relation to heart disease. Commercials and food labels even boast their product’s ability to combat its effects. Instead of categorizing this element as yet another risk factor easily resolved through medication, cholesterol should be treated as a signal that your overall health is off balance.
Before we delve into supplements to neutralize this enemy, we must first understand how and why the body uses cholesterol. Described as a soft, waxy substance, usually linked with body fat, cholesterol is necessary for daily function. We are intended to have some cholesterol. In fact, it’s needed by cells to make their outside wall, the cell membrane. This includes heart, liver and brain cells. Cholesterol is also a building material for many of our hormones, like testosterone, DHEA, progesterone and estrogen. The liver helps make cholesterol for these purposes, though diet provides it as well.
With such a strong case in its favor, how did cholesterol become the bad guy? Well, when the heart vessels are damaged, often due to inflammation caused by poorly managed stress, high sugar intake, too many omega-6 fats or too little omega-3 fats, cholesterol is used in the repair process. The cholesterol associated with damaged blood vessels is modified or oxidized (thanks to inflammation) and it’s the oxidized form of cholesterol that’s found in arterial plaque [1]. Think of inflammation as a grill and cholesterol as a steak. This inflammation grill causes a dangerous change to the otherwise normal cholesterol, seen on the steak as it chars. The charred area is oxidized cholesterol, which is not good for the vessels and also the reason charred meat is not part of a healthy diet.
It has to be understood that cholesterol appears to be only one piece of the complex puzzle of cardiovascular disease. Nothing supports this more than the fact that, in this country, nearly half of all heart attack victims have normal LDL cholesterol numbers. The other pieces include inflammation (picked up with CRP and homocysteine levels), sugar control, exercise and stress management.
A typical cholesterol panel will include the total cholesterol, HDL, LDL and triglycerides. Although commonly thought to be different forms of cholesterol, the HDL and LDL are actually cholesterol-carrying proteins. Cholesterol is cholesterol (except for oxidized cholesterol), but its transportation vehicle in the blood varies. HDL protein carries cholesterol from the body back to the liver, limiting the potential negative effect. The higher the HDL proteins, the better. LDL protein carries cholesterol from the liver to the cells of the body. More LDL particles, combined with high levels of inflammation in the body, will increase the amount of oxidized cholesterol and significantly increase the risk of a problem. An easy, optimal goal for cholesterol numbers is an LDL, HDL and triglycerides each at 70.
There also seems to be different sizes of LDL particles, leading to a varying range of danger from each. The small, dense LDL has increased susceptibility to oxidation, so it’s more likely to promote plaque formation. It appears elevated levels of triglycerides increase the amount of small, dense LDL particles circulating in the blood [2].
Triglyceride levels demonstrate how diet influences the body. They are a measure of fat in the blood that rises significantly with high sugar intake. Clinically, patients who eat more refined sugars (sweets, cakes, processed foods) tend to have higher triglyceride readings.
So while cholesterol and its levels and sizes are extremely important in assessing health and future risk, it is hardly as easy as swallowing a pill every day. Elevated cholesterol is just one more reason to adopt strategies for optimal health: Good stress management, regular exercise and a diet rich in fruits and vegetables. You may also need to consider some additional help with cholesterol lowering strategies.
References:
1. Colpo, A. (2005). LDL Cholesterol: “Bad” Cholesterol, or Bad Science? Journal of American Physicians and Surgeons, 10 (3):83-89.
2. Wierzbicki, A. (2008). Detection of small dense LDL-cholesterol: Is it necessary to determine particle size? Future Lipidol, 3(1):23-25.
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